Influenza causes epidemics of respiratory infection in young children each winter. Children under 23 months of age, particularly those under 6 months of age are most vulnerable to suffering from complications secondary to influenza infection. Consequently, influenza vaccine has been recommended for children 6-23 months of age. Unfortunately influenza vaccine is not approved for use in children under 6 month of age who are at highest risk. Therefore, The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices has recommended vaccination of household contacts of children under 6 month of age particularly their mothers. [unreadable] [unreadable] The current study is a hospital-based study to assess the effectiveness of a program to vaccinate birth mothers and household contacts of newborns with influenza vaccine. We propose to study both birth mothers and household contacts of newborns delivered at Durham Regional Hospital and Duke University Medical Center, birthing hospitals serving Durham and surrounding counties in central North Carolina. [unreadable] [unreadable] We will implement several strategies to increase vaccine coverage rates at Durham Regional Hospital utilizing Duke University Medical Center as a control setting. Strategies will include: standing vaccine orders for birth mothers, vaccine reminders for household contacts, and a hospital based influenza vaccine clinic to increase vaccine accessibility. Vaccine coverage rates will be assessed utilizing a survey method and self report of the birth mothers. Demographic determinants of vaccine coverage and reasons for refusal of influenza vaccine will be assessed as well. This study is important and a natural study for our research group to conduct. We are currently investigating the role of influenza vaccine in children under six months of age. In addition we have recently assessed influenza vaccine coverage rates of asthmatics cared for in the Duke Health System. This study will continue to establish the role our group in the field of influenza vaccine research. This study has the potential of impacting recommendations for how best to accomplish administering influenza vaccine to women delivering newborns during the influenza season. If successful, other hospitals may adopt influenza vaccination programs of new mothers and other household contacts and potentially decrease the burden of influenza illness in young children. [unreadable] [unreadable] [unreadable]